Ceftriaxone Administration Associated with Lithiasis in Children: Guilty or Not? A Systematic Review

Abstract

Lithiasis is a known side effect of ceftriaxone administration in children. Sex, age, weight, dosage, and duration of intake have been reported as risk factors for the formation of calcification or stones in the bile and urine excretory systems of children who received ceftriaxone. The purpose of this systematic review is to investigate the reported effects of ceftriaxone administration in pediatric patients who were admitted to a hospital due to infection, the likelihood of gallstones, nephroliths, or precipitations in both the biliary and urinary systems, as well as investigate the relationship with their mother’s history during pregnancy. Original studies and literature reviews from the PubMed database were included in the study. No time limit related to research or publication was set for the articles. The results were evaluated, aiming to understand the outcomes and identify any predisposing factors relevant to this side effect. Of the 181 found articles, 33 were appropriate for inclusion in the systematic review. The administered dose of ceftriaxone presented variability. Symptoms, such as abdominal pain and vomiting, were associated with ceftriaxone-related lithiasis in many cases. It was noted that most of the results were the outcomes of retrospective observation and not of prospective randomized research. Definitively, more randomized control studies with long-term outcomes are needed to identify the exact association between ceftriaxone and lithiasis in children.

Ceftriaxone-induced severe hemolytic anemia, renal calculi, and cholecystolithiasis in a 3-year-old child: a case report and literature review

“…The majority of adverse reactions caused by ceftriaxone are relatively mild, such as gastrointestinal hepatobiliary disorders (Zeng et al, 2020). Less common ADRs include kidney injury (Zhang et al, 2023a), ceftriaxone-induced cholestatic hepatitis (Castellazzi et al, 2022;Eldougdoug et al, 2023), hemolytic anemia (Northrop and Agarwal, 2015), and lithiasis (Louta et al, 2023). However, in very rare cases, it can lead to serious ADRs, such as hemolysis crisis, renal failure, multiple organ failure (Bell et al, 2005) and even death (Van Buren et al, 2018).…”